In a ‘corner of hell’ with a killer drug: Fentanyl blamed for spike in Toronto overdose deaths

For those living and working on the frontlines of Toronto's still-simmering opioid crisis, this has been just one more dark week among many . Toronto’s overdose problem hasn’t reached the terrifying heights of Vancouver, where 101 people died from fentanyl-linked overdoses in the first four months of this year alone, and 935 people died in the west coast province from opioid overdoses last year. But that doesn’t mean it isn’t bad.“My own friends have died. My own co-workers have died,” said Zoe Dodd, who works in harm reduction at the South Riverdale Community Health Centre, just across the river from Moss Park.

Crisis ' supersedes ' concerns about possession, police say. Because of that, she adds, overdose death prevention sites like the one in Moss Park have popped up despite the threat Multiple pop-up sites have opened in alleys and community hubs in Vancouver, unsanctioned at first by city officials.

A newly-erected tent large enough for a handful of people, some chairs and a pile of overdose-prevention medication now stands in Moss Park, placed there by harm reduction workers who risked arrest Saturday in hopes the pop-up injection site can save lives.

After a spate of overdoses that has left several dead this month already, organizer Matt Johnson of the Toronto Harm Reduction Alliance, an advocacy network pushing for drug policy changes, said it was time to act — with or without the city's permission.

Toronto harm reduction advocates pushing for pop-up safe-injection sitesThe Toronto Harm Reduction Alliance and Ontario Coalition Against Poverty say the opioid crisis gripping the city is too severe to wait for the city to open its three safe-injection sites, the first of which is expected to be ready by this fall.

"We're just here to save lives, like all other first responders," Johnson said. "We can really make a dent in the number of people overdosing and dying in this city."

Given the recent spike in overdoses, Johnson said, the organization decided not to wait for permission from police or city officials. "We should have done this months ago... Morally and ethically we can't hold back any longer. We just have to be brave and go ahead and do it."

Staffed by a registered nurse, overdose prevention trainers eager to share life-saving skills, and outreach workers tasked with scouring the park for used needles, the tent will welcome anybody who wants to use drugs and administer naloxone, the anti-overdose medication, to those who need it.

Toronto harm reduction advocates pushing for pop-up safe-injection sitesThe Toronto Harm Reduction Alliance and Ontario Coalition Against Poverty say the opioid crisis gripping the city is too severe to wait for the city to open its three safe-injection sites, the first of which is expected to be ready by this fall.

Toronto police spoke with organizers as the tent went up, ultimately deciding to allow it to operate for the time being.

"As Toronto knows there is an absolute crisis on the streets right now," said superintendent Heinz Kuck of the Toronto Police Service.

"Although Toronto Police doesn't necessarily agree totally with an injection site like this popping up, because we do have the aspect of illegal drugs coming and going, the crisis supersedes that at this point in time."

Kuck said it'll be "business as usual" for officers patrolling the area, with no more officers there than usual — and all will be directed not to target anyone using the site at least for tonight.

He added that the "absolute professionalism" of the site's organizers and the process they've set up, which includes medical professionals on staff and safe disposal bins for used needles, convinced him to allow the site to remain open.

'We had people waiting for the tent to open': unsanctioned injection site wants to stay for good

An unsanctioned overdose prevention site, where people can use drugs under the supervision of a nurse, opened in Moss Park yesterday with police approval, but workers say they need long-term stability.One of the site's founders, Matt Johnson of the Toronto Harm Reduction Alliance, said the pop-up injection site has been so welcomed that people were waiting for the tent to open again on Sunday so they could consume drugs such as heroin and cocaine under supervision of the site's harm reduction workers.

Toronto Harm Reduction Alliance are planning to open the first unsanctioned pop-up safe injection site at an unannounced east-end park on Saturday. The location has now been revealed as Moss Park . While police told organizers they are breaking some bylaws, they are currently being allowed

Run exclusively by volunteers, workers have 140 overdose kits on hand — a mix of injection and nasal spray kits, each containing latex gloves and multiple doses of naloxone. Organizers also plan to distribute kits containing clean needles and crack pipes to reduce the transmission of infections.

Although Kuck said he's not sure what will happen to the site after Saturday night, at this time he said, "we're going to allow this to take place for the interests of the Toronto people."

Pop-up sites work, says nurse

Marilou Gagnon is a nurse and assistant professor at the University of Ottawa who founded an advocacy network that champions supervised injection facilities. She said there's a risk with sites that haven't received an exemption from Health Canada — technically, they're illegal, and anybody using or working may be arrested.

But applying for that exemption "is long and and it is expensive," Gagnon said. Because of that, she adds, overdose death prevention sites like the one in Moss Park have popped up despite the threat of legal consequences.

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While a federally-approved supervised injection site offers more resources, Gagnon said, a pop-up has the advantage of rapid response.

"It can be outdoors, indoors, it can be in a trailer — whatever you can put your hands on. The simpler the better, the cheaper the better. It's quick, you can implement it. And then you're focusing on saving people's lives if they overdose," she explained.

Multiple pop-up sites have opened in alleys and community hubs in Vancouver, unsanctioned at first by city officials. But police made no arrests, Gagnon said, and the city's public health authority eventually endorsed the sites as a means of battling the crisis. "We know they work," said Gagnon.

Alternative approach to illicit drug use

Johnson stressed that organizers view the site as a "public health initiative" that will benefit people who use drugs and the public alike.

"I'm not going to try to convince people that drug use is okay," he said. "Whether you agree with it or not this is going to reduce the harms, reduce the impact on your community."

There's no hard and fast opening date for Toronto's three federally-approved supervised injection sites, the first of which is expected to open some time this fall, he pointed out. Because of that uncertainty, Johnson said he's "terrified" the unsanctioned site will be dismantled with nothing to replace it — a possibility given they're lacking Health Canada's stamp of approval — leaving people without help lest fentanyl strike.

For now he hopes law enforcement will continue to see the site as beneficial.

"We can't arrest our way out of this problem. It hasn't worked, it's not going to work. The drug war has been going on for decades and it's an abject failure," Johnson said.

"It's time we try something new."

Toronto unveils interim safe injection site .
An interim safe injection site in Toronto — the first such officially-sanctioned facility in Canada's most populous city — will save lives as the city grapples with a spike in suspected overdoses, public health officials said Monday as the temporary location opened its doors. The site, which can accommodate three people at a time, is at Toronto Public Health's downtown harm reduction facility, known as The Works. It launched a day after receiving approval from Health Canada and about a week after harm reduction advocates set up an unsanctioned injection site in a city park.

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